Environment and Communication Assessment Toolkit (ECAT) for Dementia Care

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"A unique resource for health professionals who work with individuals with dementia. It combines content information, assessment tools, and practical tips and strategies in a format that is engaging and easy to read. Everyone from beginning clinicians to seasoned professionals will find this manual invaluable in managing patients with dementia and maximizing their functioning in EVERYDAY LIFE." LYN TURKSTRA, Ph.D., DEPARTMENT OF COMMUNICATIVE DISORDERS, UNIVERSITY OF WISCONSIN–MADISON

98% of professionals in a study report: “The ECAT gave me new treatment options to use!”

FINDING SIMPLE SOLUTIONS TO IMPROVING THE LONG-TERM CARE ENVIRONMENT

1-888-337-8808  410-337-9585 www.healthpropress.com P.O. Box 10624, Baltimore, MD 21285-0624


Environment & Communication Assessment Toolkit for Dementia Care by Jennifer Brush, Margaret Calkins, Carrie Bruce, and Jon Sanford

As communication skills decline in people with dementia, a supportive environment becomes crucial to a resident’s abilities to express

needs and desires. ECAT for Dementia Care (ECAT) is an evidence-based toolkit to help you recognize what physical and social changes will help you improve functioning and communication. Here are critical assessment tools and intervention procedures to ensure the highest quality of life for people with dementia. In three easy-to-follow steps, the ECAT Assessment Forms help you

TRIED BY CLINICIANS AND LOVED!

“Prior to the [suggested] $10 modification [in one client’s bathroom] …[we had] a HUGE hygiene issue. Now she demonstrates great hygiene without cuing!!! SUCCESS!!”

• • • •

Record activity performance deficits with quick yes/no questions Evaluate the environment to identify barriers and problems Pinpoint individualized recommendations for interventions Reduce barriers to functioning

ECAT is not only person-centered but also real world. ECAT’s developers are researchers and experienced clinicians who’ve made sure that the toolkit • Integrates effortlessly into evaluation and treatment sessions • Helps in keeping up with case load demands with creative solutions • Satisfies regulatory requirements • Leads to straightforward functional therapeutic interventions • Identifies low-cost, person-centered environmental modifications

ECAT for Dementia Care has more than 300 specific recommendations for interventions and modifications that reduce typical problems encountered during routine activities of daily living for people with dementia. Discover for yourself the surprisingly simple environmental changes that can improve functional independence and resident well-being. Reap the immediate results of putting these solutions to work.

Environment & Communication Assessment Toolkit Includes: ECAT Manual* including Intervention procedures

ECAT Assessment Instruments ECAT Assessment Forms* Evaluation of Personal Spaces Evaluation of Public Spaces Gray Scale Contrast Tool Type Size Reading Test Sound Meter† Light Meter† ECAT Card Pack* with sequencing cue cards and more ECAT Assessment Instruments & Intervention Tools CD-ROM with printable PDFs of Forms, Cards, and more US$299.95 (including meters†) | ISBN 978-1-932529-85-2 US$124.95 (without meters†) | ISBN: 978-1-932529-84-5 * Asterisked items may also be purchased separately. For more product details and component pricing, visit http://www.healthpropress.com/ECAT

ECAT At a Glance

Where to Use: Long-term care settings (assisted living, skilled nursing, and memory care) and home settings. What is Assessed: Personal spaces and public spaces, visibility, wayfinding and navigation, contrast, sound and light levels.

Intervention Guidelines: The ECAT Manual provides detailed intervention recommendations correlated to assessment results. Who Completes the ECAT: Speech-language pathologists, occupational and physical therapists, nurses, social workers, case managers, therapeutic recreation professionals, other dementia care professionals. Time Required: 30–60 minutes depending on individual’s level of functioning and supportive features in environment. Training Required: The ECAT Manual provides all information needed for assessments and intervention implementations. Evidence Base: Funded by the National Institute on Deafness and Other Communication Disorders. Across 3 years rigorous feasibility and utility testing yielded significant results, reported in the ECAT Manual. Additional study with SLPs, OTs, PTs, and nurses showed positive outcomes on four measures: awareness of environmental interventions, impact on practice, utility of the information, and usability of the materials. Expert Developers and Advisors: ECAT was developed by a team of speech-language pathologists and architects who specialize in dementia care, with the support of an expert Technical Advisory Committee from speech-language pathology, occupational therapy, physical therapy, nursing, and gerontology, as well as a Clinical Review Panel of rehabilitation, nursing, and activity professionals working in long-term care communities.


How ECAT Works ECAT Manual The ECAT manual is an educational tool that has been designed to provide the clinician with greater knowledge about the effect of the environment on communication performance in the long-term care setting. It discusses how functional limitations associated with dementia can impact a person’s ability to communicate, and how the physical and social environment can help compensate for these limitations. The ECAT Manual will help the clinician •

• •

Gain better understanding of how the environment impacts various aspects of communication for a client with dementia Understand how to identify environmental barriers that affect communication during routine activities Learn about a wide range of environmental interventions that support communication

Assessment Instruments The Assessment Instruments comprise instructions and a set of tools for collecting the information necessary to identify environmental barriers and facilitators, including the assessment forms, a gray scale to assess contrast, a reading test to determine appropriate type sizes, and sound and light level meters. Use the ECAT Assessment Instruments to identify any environmental factors that may exist that would prevent or deter the client from participating in activities of daily living, leisure activities, or social communication.

Intervention Procedures and Resources ECAT provides many practical recommendations and resources, including information on developing visual cues and reading material, and an overview of lighting. Instructions are also included for using the personal space signs and sequencing cards for activities of daily living that are included in the ECAT.


“Long overdue…tools needed by speech-language pathologists to determine the appropriate environmental cues for their clients with dementia to maintain a quality of life in the nursing home.” MICHELLE BOURGEOIS, Ph.D., CCC/SLP, DEPARTMENT OF SPEECH AND HEARING SCIENCE, THE OHIO STATE UNIVERSITY

Make ECAT work for you To evaluate the effectiveness of the materials, ECAT was implemented by a diverse group of 63 speech-language pathologists, occupational therapists, physical therapists, and nurses who used the toolkit with their clients for 6 months. The effectiveness of ECAT was measured by four factors:

Awareness: The increase in awareness of environmental modifications prior to and after ECAT training was highly significant

Impact: After using ECAT for just 5 months, the majority of clinicians used 80% of the modifications, and more than half of the clinicians continued to use ECAT on their own as part of their clinical practice after they met the requirements of the study.

Utility: 9 out of 10 clinicians agreed or strongly agreed that ECAT for Dementia Care had useful information, added value to their clinical practice, and benefited their clients. Usability: Over 90% of clinicians agreed or strongly agreed that the information was easy to understand and that the ECAT was easy to use.

See for yourself! Lead author Jennifer Brush describes in a brief, informational video the components of ECAT and how simple it is to begin using this powerful assessment toolkit. View now at www.healthpropress.com/ECAT

About the Authors Jennifer Brush, M.A., CCC/SLP: Senior Project Director at I.D.E.A.S., Inc., Executive Director of IDEAS Institute, and nationally recognized speech-language pathologist, particularly in the areas of memory and swallowing interventions for people with dementia.

Margaret P. Calkins, Ph.D., CAPS, EDAC: President of I.D.E.A.S., Inc., Certified Aging-in-Place Specialist, and one of the first professionals to receive the Evidence-based Design Accreditation and Certification.

I.D.E.A.S., Inc. (Innovative Designs in Environments for an Aging Society, Kirtland, Ohio) provides expertise on environments for people with dementia. Its mission is to engage in research, education, and consultation on the therapeutic potential of the environment— organizational and social as well as physical— particularly as is relates to frail and impaired older adults.

Carrie M. Bruce, M.A., CCC/SLP, ATP: Research Scientist at the Center for Assistive Technology and Environmental Access at Georgia Tech in Atlanta and licensed speechlanguage pathologist and assistive technology practitioner.

Jon A. Sanford, M. Arch: Director of the Center for Assistive Technology and Environmental Access and Associate Professor in the College of Architecture at Georgia Tech.

is a registered trademark of I.D.E.A.S., Inc.


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